Intermittent Self Catheterisation (ISC)
This technique is a method of emptying the bladder using a tube (catheter - normally single use and disposable) in a manner which is quick, convenient and fits into everyday life.
The technique is not new and evidence can be found of the ancient Egyptians performing this technique using onion skins! Things have moved on somewhat and the catheters advocated today are usually plastic, some may be coated with a substance which helps them not to stick and cause discomfort during use. There are many varieties on the market and any user should seek the advice of a Urologist, Continence Advisor or other professional when deciding which catheters to use.
Some sufferers of Interstitial Cystitis (IC) are unable for a variety of reasons to completely empty their bladders leading to pain, discomfort, frequency and urgency and it may be suggested that they try ISC in order to overcome their problems. Again advice should be sought if you feel you may be helped by this technique. Who teaches you this procedure depends on local practice. Whoever it is, they will be able to talk through with you both the theoretical reasoning behind the need for you to undertake it and secondly the practical methods of how you perform the procedure. They will provide you with literature, samples and ongoing support until you feel fully confident with the technique.
The most important aspect of this technique is that it is undertaken as a way of improving your quality of life, allowing you to do the things that your bladder problems prevent you from doing. Therefore once learnt it should fit in with your everyday routine, require minimal equipment and only the people you choose to tell will know that you are doing it. In my area we try to visit patients at home in order that they can try the technique with our guidance in an environment which is relaxed and familiar to them.
The frequency with which this technique needs to be performed will vary from one person to another and you will be guided by the professional caring for you.
At first the procedure can be a little tricky to learn, however with time, practice, patience and the support of a professional who is used to teaching this technique, most people become very efficient remarkably quickly. Age, poor eyesight, dexterity and not being able to position oneself easily in order to undertake the catheterisation can sometimes be awkward but most people learn given adequate time and support.
Many of my patients are worried about the risks of infection associated with inserting a catheter into the bladder. Research shows that the risk is low and this is mainly due to the types of catheters used, the fact that they are not left in place long term and more importantly that the patient is undertaking the procedure on themselves, using disposable products in their own home environment. Advice regarding minimising infection risks can be sought from your nurse.
Catheters should be disposed of according to local policy and again advice can be sought from your local Continence Advisory Service.
Long term supplies of products are obtained on prescription from your GP. Some manufacturers have their own dispensing and delivery service and again advice can be sought from whoever teaches you the procedure.
ISC will not be suitable for all IC sufferers but if it is recommended to you, it is worth a try. There is a national network of Continence Advisors as well as hospital urology nurses and community nurses who can help and support you with this technique.
You can contact your local Community Continence Advisor by contacting the Association of Continence Advisors on 020 7820 8113, or the Continence Foundation on 020 7831 9831.
At the charity offices we have a supply of booklets on techniques for Intermittent Self Catheterisation. If anyone would like a copy please send us a stamped addressed envelope measuring at least 22cm by 16cm with 35p postage (42p 1st class) and we will send you a copy. Please mark your envelope ‘ISC Brochure’.